Parkinson disease pathogenesis may affect migraine severity due to the impact of progressive brainstem degeneration.

The onset of Parkinson disease (PD) is associated with reductions in the severity, intensity, and frequency of migraines, according to results from a multicenter, case-controlled study published in Cephalalgia.

The study investigators compared the prevalence of migraines and headaches among patients with PD (n=436) and age- and sex-matched controls (n=401). The investigators sough to assess changes in the frequency, intensity, and severity of headaches around PD onset among patients with a history of migraines or headaches compared with patients without PD who also had a migraine and headache history.

Overall, patients with PD had a lower lifetime prevalence of migraine (9.6% vs 18.0%; P =.00045) than controls. Additionally, patients with PD had a lower 1-year prevalence of migraine compared with the control group (6.7% vs 11.0%, respectively; P =.027).

Lifetime headache prevalence (38.5% vs 38.9%; P =.91) as well as 1-year headache prevalence (26.1% vs. 26.2%; P =.99) did not differ significantly between patients with PD and controls. The onset of PD coincided with a reduction in frequency, intensity, and severity of headaches and migraines.

Patients with PD and migraines were also more likely to have depression and higher Pittsburgh Sleep Quality Index and PD sleep scale-2 scores compared with patients without headaches.

Some of the limitations of this study include its case-control design, the lack of data on headache and migraine treatments, and that the majority of patients were being treated with dopaminergic drugs.

Irrespective of the proposed limitations, the investigators suggest PD pathogenesis may have an impact on migraine severity because of impacts of progressive brainstem degeneration leading to disruptions in pain regulatory systems.